WHY IT MATTERS: Opioid Epidemic

CONCORD, N.H. (AP) — THE ISSUE: More Americans are dying from opioids than at any time in recent history, with overdose deaths hitting a peak of 28,000 in 2014. That amounts to 78 Americans dying from an opioid overdose every day, according to the Centers for Disease Control and Prevention. The CDC uses opioid as an umbrella term for synthetic painkillers and for drugs derived naturally from opium (known more specifically as opiates), such a heroin.

It's not just the use of illicit opiates like heroin that is on the rise — overdose deaths from prescription painkillers have quadrupled since 1999, tracking a similar increase in the amount of these drugs being prescribed by doctors.

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WHERE THEY STAND

Donald Trump sees his plans to build a wall along the Mexican border as essential to stopping the flow of illegal drugs into the country. The Drug Enforcement Administration reports the seizure of drugs at the Southern border quadrupled between 2008 and 2013. Hillary Clinton proposes spending $10 billion to tackle the drug crisis. Her plan would send more money to states to expand drug treatment and mental health services, promote greater availability of the overdose reversal drug naloxone and support better prevention programs in schools, among other things.

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WHY IT MATTERS

More than 2.4 million Americans were addicted to synthetic pain relievers or heroin in 2014, according to the latest federal survey on drug use and health. And that number excludes the millions more — family members, first responders, taxpayers — who feel the ripple effects of addiction in their daily lives.

Clinton has called drug addiction a "quiet epidemic." But it's one that's getting louder, as more and more Americans share their stories and prove that drug addiction follows no standard profile of age, race or class.

For decades, drug addiction was viewed as a criminal justice problem, not a health one. The stigma is lessening, but many states simply don't have the capability to provide treatment and recovery for people who need it, leaving police departments and emergency rooms to fill the void. Lawmakers and advocates are fighting for precious tax dollars to expand services, but the 2015 National Survey on Drug Use and Health found that just 0.9 percent of people seeking treatment for a problem related to drugs or alcohol received it.

Experts now believe the sharp increase in prescribed painkillers is to blame. People are quick to share stories of being prescribed dozens of pills for pain relief following procedures as simple as wisdom teeth removal. The strength of these medications can easily cause addiction, forcing many people to turn to a cheaper alternative — heroin — when their prescriptions run out. Roughly 75 percent of new heroin users report first using prescription opioids, the government says.

Lawmakers are beginning to take notice: At the meeting of the National Governors Association in July, 45 governors signed on to a compact aimed at tightening prescribing rules. Several attorneys general are engaged in or considering waging legal battles against major pharmaceutical companies, alleging they played down the risks of addiction when marketing their painkillers.

At the same time, the illicit drugs people are turning to are becoming even more deadly. The synthetic painkiller fentanyl, which is up to 50 times as potent as heroin, is now being manufactured illegally. By sight, it's impossible to tell the difference between heroin and fentanyl, leaving people unaware of the deadliness of the drugs they are consuming. Northeastern and Midwestern states, such as New Hampshire and Ohio, are seeing a dramatic rise in the use of fentanyl. More than 5,000 people nationwide died from a synthetic opioid like fentanyl in 2014, and that number is only on the rise.

As most politicians know, families and communities are demanding change, and fast.

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This story is part of AP's "Why It Matters" series, examining three dozen issues at stake in the presidential election. You can find the series at http://apne.ws/2bBG85a